The pain which a person experiences as a result of having a herniated disc can be quite debilitating, to tell you the truth. However, taking into due account the fact that all a person in such a situation would want would be to be up and running as soon as possible.

In order for this to happen, as would be expected, he or she would need to go through the options which are available for treatment of a herniated disc. There are various types of herniated disc treatments which are available though it can be said that conservative treatments are preferred as these treatments do not require surgery to be carried out on the person who is suffering from the issue.

The course of this sort of treatment lasts somewhere between one month to one and a half months. The aim of conservative treatment is to reduce or minimise the pain that is automatically associated with a herniated disc. There is a strategy to help a person improve by which he or she is provided with medicine for the purpose of pain relief while physiotherapy is made use of to make the underlying condition better.

Surgical treatment may be required, if the case is such that the person has lost a great degree of function and is in pain that seems to be pretty much unbearable. `If the person has a lumbar herniated disc, then the conservative treatment for this sort of case would require him or her to apply ice and heat from a warm source to provide relief to the area. If the pain is very bad yet the person is determined not to undergo surgery then the answer would be to consume some oral steroids or narcotic pain medications. One should surely keep in mind that this is only to carried out as per the prescription of a doctor who is trained and experienced to a sufficient degree.

If surgery is required for this sort of herniated disc, then it is likely to be a lumbar decompression surgery which aims to allow for the growth of the spine back to health as a result of removing the herniated disc. When it comes to cervical herniated disc treatment, conservative solutions include using drugs like ibuprofen and physical therapy; similar to solving lumbar herniated discs. However, surgical treatment for cervical herniated discs warrants anterior cervical decompression; where the disc is removed from the front of the neck.

 What Therapy Is Best For Herniated Disc?

Torn cartilages are quite a common form of injury occurring in the human body. While one can t always be too cautious of injuries, one can still try to be conscious of their muscles and do not move about in an abrupt manner to cause injury to themselves. Further, even though torn cartilages are very common, they are quite painful and most often they occur in the knee. Here are some tips to ensure that your torn cartilage heals well and you are exposed to less pain during the healing period:

Rest: You must take rest. While it is advised to take bed rest, humanly it is impossible to spend all day in bed. Thus one can move about a little but avoid walking and straining their legs and knee too much. At times crutches can be taken while taking a few steps in the room.

Ice Therapy: Putting ice bags in the affected area helps in relaxing the muscles and reducing the pain quite a lot. Though previously people adhered to putting hot water bags, the scenario is slowly changing to ice therapy.

Compress: When you are suffering from a torn cartilage, the doctor often puts a bandage on the knee to compress the area. This is done so that the muscles are brought together and they can heal on their own with time and rest.

Elevate the Knee: Often it is seen that during such cases, the knee or the hands are rested in an elevated platform. This platform is created with the help of a pillow mostly. This lets the cartilage get time to rest and heal on its own.

Avoid Strenuous Activities: This includes jumping, running, jogging, kicking etc, when it comes to the legs and writing, lifting weight etc. when it comes to the hands. These activities require a lot of strength and power and most of all the use of the cartilages. Since the cartilages are torn and in their healing mode, it is best to avoid such activities for a certain amount of time to not put pressure on the cartilages and damage them further.

Painkillers: It has been already mentioned that the healing period can be painful. Thus, the doctor may prescribe some painkillers to ease the pain during this time.

Thus, these are some of the easiest ways to deal with a torn cartilage. The recovery period may be painful, but it happens to many people and is completely healable in nature.

How To Deal With Torn Cartilages?

As life expectancy is increasing so is the incidence of vertebral body (VB) fractures now being the commonest fracture of the body. PVP is an established interventional technique in which bone cement is injected under local anaesthesia via a needle into a fractured VB with imaging guidance providing instant pain relief, increased bone strength, stability, decreasing analgesic medicines, increased mobility with improved quality of life and early return to work in days.

In this era of minimally access surgery replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression fracture spine.

Morbidity & consequences of spinal fracture:

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory & GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc element
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Results / Outcome

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral.
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Percutaneous Vertebroplasty (PVP) is an emerging interventional technique in which surgical polymethyl methacrylate bone cement is injected under local anaesthesia via a large bore needle into a vertebral body (VB) under imaging guidance providing increased bone strength, stability, pain relief, decreased analgesics, increased mobility with improved QOL and early return to work. Started in 1984 by Galibert PVP is done in host of indications.

Senile osteoporotic compression remains the commonest Indication. Other indications are Metastatic VB, Multiple myeloma VB, VB haemangioma, Vertebral osteonecrosis & for strengthening VB before major spinal surgery. The benefit has been extended to the traumatic stable uncomplicated VB compression (VCF) which is commoner in younger age group with active life profile and prime of their career where strict bed rest and acute or chronic pain are unacceptable and they are more demanding for proactive treatment approach so as to be back to work ASAP.

Discovering the fact that VB is the commonest of body, its incidence >the hip, it becomes imperative to take it more seriously. With increasing life-span there is more of aged osteoporotic population, more so due to sedentary indoor lifestyle and post menopausal osteoporosis. Diabetics, smokers & alcoholics are at higher risk of developing osteoporosis. I have seen such alcoholic patient developing six spine fractures in just three months time from a single fracture being on complete bed rest.

Quick fix of fracture spine makes patient walk back same day instead of bed rest of months together avoiding morbidity & mortality of prolonged bed rest, making bedridden patient walk, in a way bringing patient back to normal life.

In this era of MAS replacing open surgeries, PVP is a novel procedure & should be in the first line of management in place of conservatism or major spine surgery for painful uncomplicated compression.

Morbidity & consequenses of spinal 

Traumatic VB is a painful condition requiring bed rest restricting daily activities markedly.
Left untreated it can cause DVT, increase osteoporosis, loss of VB height, respiratory &
GI disturbances, emotional & social problems secondary to unremitting pain, loss of independence with high cost of rehabilitation.
High risk of primary or consequential damage to neural, bony or disc elements.
Increased wedging, deformity & increase incidence of adjacent VB
Chronic pain of altered spine mechanics.
Uncomfortable braces & sleep disturbance because of pain & discomfort with its sequels.
Morbidity and complication of spinal surgery 

Cost of surgery and hospital treatment
Cost of implants
Phobia of surgery
Prolonged recovery period & Extensive rehabilitation
Changed spinal mechanics & transition syndrome
Major surgery & anesthesia with its own complications
Preparation & Procedure:
X-ray spine in a/p & lat view. CT is more informative of bone & morphology. MRI is good for soft tissue injuries. Ask for pedicle size in all dimensions and construct a 3D image aiming needle placement and cement filling in scan room itself as rehearsal of PVP. This reduces operative time & gives better results. Conventionally PVP is done by hammering the vertebroplasty needle through the bone. Here we use light weight drill to bore through the vertebra. It is important to set the needle at exact entry site & side with right trajectory aiming the defects.

In lateral view needle should go through middle of the pedicle going up to anterior 1/3 of VB. In P/A view the needle can be in midline or paramedian depending upon & if uni/bipedicular approach is planned. Approach varies as per location of vertebra, anterolateral in cervical, costotransverse/parapedicular in thoracic & transpedicular in lumbar vertebra.

Do bone biopsy if there is any doubt about lession. Do dye test (vertebral venography). Make cement more radiopaque by adding barium /or tungsten. Inject cement with 1or2 ml luerlock syringes strictly under fluoroscope in lateral view & cross checking in P/A view. Stop injecting either there is adequate filling or at the first sight of ectopic cement leak. Keep sample cement to see for hardening. Remove needle with rotational movement before cement hardens.

Pain relief is by virtue of different mechanisms postulated :

Cementing of fragments.
Thermal neurolysis of VB nerve ending due to heat of polymerization.
Washing away of nociceptor chemicals.
Neurolytic action of liquid monomer.
By allowing early ambulation decreasing pains of immobility & bed rest.
Complications 

PVP is generally safe with low risk.
Ectopic cement leak is frequent but generally inconsequential.
Outcome 

PVP is a novel procedure with high benefit to risk ratio, which is highly underutilized in relation to the high prevalence of the vertebral
Different studies show an immediate pain relief in (85   90)% of patients with low complication rate ranging from (1-5)% depending upon the type of lesion.
PVP does augment height of VB but ideal would be kyphoplasty.
Patient is either off medicine or on reduced doses.
Patient feels so well that he almost forgets if he had VB

Vertebroplasty (PVP) / Kyphoplasty - Approach To Management Of Vertebral Body Fractures!

In Ayuveda, muscle cramp is known as  khalli vaata . Vyaana vaata it is a biological force that is responsible for regulating the functioning of your voluntary muscles. In case of a muscle cramp, the vyaana vaata gets impaired. Metabolic wastes are harmful toxins that tend to get accumulated in your system if not flushed out of your body and deposited between your muscle tissues and nerve-endings. This toxic waste is known as 'aama' in Ayurveda and it is known be a prominent cause of cramps. Besides aama, vata dosha is also responsible for muscles cramps.

Ayurveda provides a number of remedies to treat the problem of muscle cramps. The following are some of the most effective remedies to relief the discomfort of muscle cramps:
1. Drink warm milk to get instant relief from abdominal cramps. The alkaline properties of milk help to pacify the acidic condition in stomach that results in cramps. It is also a rich source of calcium which is known to aid in the relaxation of troubled muscles.
2. Physical activity including stretching exercise is effective in reducing the acute pain of leg cramps.
3. Garlic compound which is also called as 'Lagsunadivati' is helpful in relaxing muscles and it is also known to calm the  vata dosha  that aids in relieving muscle cramps.
4. Do warm up exercises and stretching exercises to lessen the risk of developing a muscle cramp during your workout session
5. Increase the intake of foods that are rich in minerals, calcium, potassium and magnesium as it is known to reduce the chances of muscle cramps.
6. Massage the painful region with 'prasarini taila' or 'mahanarayana taila' to relax the strained muscle.
7. Apply ice pack on the strained muscle to reduce the swelling and pain of the muscle.
8. Sinhanaada guggulu is well known to provide instant relief from muscle cramp. It has medicinal properties which have a mild laxative effect. It eases the problem of abdominal cramps and lessens the discomfort associated with it.
9. In case of extreme pain, 'Lakshmivilaas rasa',  Prataapa lankeswara rasa , are among the most effective Ayurvedic medications which are known to provide relief in case of chronic muscle cramps.

Muscle Cramps - How to Treat them Effectively through Ayurveda

One part of the human body is essential for the efficient functioning of another. The hip joint provides support to your overall body weight while you are at ease or in motion. Suffering from medical problems pertaining to the hip can impede free movement; walking, running, stooping, sitting or even lying down will cause immense pain and discomfort in such a situation. While certain bodily disabilities come with old age and are in most cases unavoidable; some others can actually be controlled through physical exercise.

Take a look at a few stretches to improve your hip mobility:-

Stretch like a pigeon- this yoga loosens up muscle tension in and around a person's hip. Your right leg must be stretched behind while the upper part of your body bends over a folded left leg in front. Your head rests on your coupled hands. This stretch improves the shape of your hip as well.
Try to be an eagle for hip firmness- to align your body in the perfect eagle pose; you probably need to be a conjurer; that is the kind of flexibility the posture requires. Be a half chair making your hands intersect above your head while your left leg crosses the right one. The pressure is on your hip making it strong. Your body has to be in one single line.
Sit in the chair pose- crouching on your haunches with your torso inclined to the front is a good way to better hip mobility. This exercise also relieves you of back pain. It adds potency to the muscles of your upper thighs thus giving a well- rounded hip extra support.
Stoop in the downward doggy pose- the downward doggy pose helps you concentrate on the fullness of your hips. The back muscles are stretched and the problem of a small, rickety hip is dealt with through this yoga. Your legs should be erect at the knees and should be stretched apart depending upon the width of your hip. The rest of your body should bend in a forward arch while your spread hands touch the ground.
Try out the benefits of world's greatest stretch- world's greatest stretch involves a series of stretches that not only accentuates your hipline making your hip muscles adaptable to stress but also tones muscles in other parts of your body. It is a three- fold exercise. The second step is the most difficult where your body is balanced on a half folded right leg and you're required to touch the ground with your right elbow.

Tips to Improve Hip Mobility

The most common cause of neck pain can be cervical disc disease. It is generally caused by the abnormality of the disc that is the cushion present between the vertebrae. The disc can get damaged because of arthritis or any unknown cause. When damaged, it usually leads to inflammation or spasm of the muscles leading to neck pain. There are a number of pain medications, traction exercises, and physical therapy for minimizing the neck pain. However, these home based remedies help in relieving pain along with a speedy recovery:

*  Take it easy: If you have a busy and hectic life, then take it easy. Living with cervical disc diseases can lead to an increase in the neck pain; thus cutting down on activities helps. A comfortable position should be observed while resting. If need be then a pillow can be placed under the neck.

*   Apply Cold/Heat Pack: There is always a confusion regarding whether a cold or a hot pack is to be used. The recommendation is to use ice or cold pack for the first 24 to 48 hours of the injury, so that the swelling subsides. This should then be followed by hot fermentation in order to improve the muscle stiffness and also loosen them. But in case of a cervical disc disease neither cold nor heat penetrates the tissue to relieve inflammation, so it is best to use the one which feels better. Whichever, pack is chosen it should only be used for 20 minutes and then left for 40 minutes. Take care and do not use ice or heat directly against the skin. 

*  Stretch: Stretching exercises should be done in order to improve the flexibility and relieve pain in the neck. Exercises can be performed after warming up of the muscles by a warm towel or bath. Here are a few simple stretches for cervical disc disease that you can do at home:

* Move the neck: As per the study by the American Medical Association, women who had neck pain got relief when they did exercises using light weight and resistance bands. This increased their endurance and strength of the neck muscles. Also, 30 minutes of exercise in the form of biking, walking, swimming, and biking is recommended to improve the blood flow.

*  Maintain the posture of the neck: A bad posture can cause a neck pain. Every time while standing, sitting, walking, lifting the posture should be kept in mind. The head and neck should be kept straight and the back should be supported in order to avoid neck pains.

Neck Pain and How To Deal With It

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